AB0695 SJÖGREN’S SYNDROME: ORAL MANIFESTATIONS, ITS IMPACT ON ORAL QUALITY OF LIFE AND RELATIONSHIP WITH DAMAGE AND DISEASE ACTIVITY
Authors: L. Ingolotti, A. Secco, M. Bejarano, M. N. Tamborenea, A. L. Mercé, C. Arguissain, M. L. Martin, J. Morbiducci, V. Azcona, L. Teplizky, E. Casals, A. Hernandez, M. Marseillan
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Involvement of oral cavity have been described in patients with primary Sjögren Syndrome (pSS). Research about how oral health affects the quality of life in pSS is lacking, for this reason we conducted this study. <h3>Objectives</h3> 1-To establish the presence and characteristics of oral involvement in patients with pSS. 2-To assess the quality of life related to oral health. 3-To assess relationship between the quality of life related to oral health and saliva production, disease activity, and damage. <h3>Methods</h3> An observational, analytical and cross-sectional study was conducted. Patients aged ≥18 years who met the European-American 2002 and/or ACR-EULAR 2016 classification criteria for pSS were included. Patients with another rheumatic disease and/or conditions that favor the appearance of caries were excluded. The quality of life related to oral health was evaluated by the abbreviated version of OHIP Oral Health Impact Profile questionnaire (Oral Health Impact Profile-OHIP14sp) validated in its Spanish version, a self-administered generic questionnaire (score 0-56 meaning the highest, the worst). A rheumatologist performed visual analogue scale (VAS) for xerostomia (0-100mm) ESSPRI (EULAR Sjogren's Syndrome Patient Reported Index) ESSDAI (EULAR Sjögren's Syndrome Disease Activity Index) and SSDDI (Sjögren's Syndrome Disease Damage Index). A dentist assessed oral health using the DMFT (number of Decayed, Missing, and Filled Permanent Teeth) index, it quantifies the prevalence of caries and its results are expressed as follows: 0-1.1 very low prevalence; 1.2-2.6 low, 2.7-4.4 moderate, 4.5-6.5 high and ≥6.6 very high). The O'Leary index and Loe &amp; Silnes index were also calculated (the first evaluates dental hygiene, a value of &gt; 10% determines poor hygiene; and the second one measures bacterial plaque categorized as 0,1,2 and 3, category 3 represents the greatest thickness and extension). Continuous variables were reported as mean and standard deviation or median and interquartile range, according to distribution. Categorical variables were reported as percentage. A multiple linear regression model was performed, taking OHIP14sp as the dependent variable, adjusted for possible confounders. <h3>Results</h3> 51 patients were included, 98% were female, mean age 54 (±13 years). The OHIP-14sp median was: 16 (6-25), xerostomia VAS median was 60 [30-80]. Mean of ESSPRI was 4 (± 2.6), ESSDAI median was 0 (0-2), SSDDI median was 3 [2-4]. Unstimulated saliva flow rate was positive in 75% of patients, the median was 0.7 ml (0.5-1). ANAs were positive in 90%, Anti-Ro autoantibodies were positive in 74.5%. Regardless treatment, 56% were treated with conventional DMARDs (75% received hydroxychloroquine), 4% DMARDb, and 9.8% received glucocorticoids with a median dose of 10mg/day [5-20]. 60% were treated for xerostomia xerostomia (M agonists or salivary substitute). Oral involvement occurred in 100% of patients, DMFT median was 22 [14-28]. 88% had poor dental status, O'Leary index median was 21 [13-30]. The Loe &amp; Silnes index was 1 in 51%, 2 in 18.9% and 3 in 8%. In the univariate analysis, OHIP14sp was significantly associated with ESSPRI (β coefficient: 2.04 95% CI 0.72-3.3), xerostomia VAS (β coefficient: 0.19 95% CI 0.08-0.29) and category 2 of the Loe &amp; Silnes index (β coefficient: 18 95% CI: 5-31). In the multivariate analysis, OHIP14sp was independently and significantly associated with xerostomia VAS (β ccoefficient: 0.19 95% CI 0.09–0.29) and category 2 of the Loe &amp; Silnes index (β coefficient: 19 95% CI:7.7-29.7) <h3>Conclusion</h3> In our study the entire population included had oral involvement, with impaired oral quality of life, and related significantly with the degree of dryness measured by xerostomia. Our findings support the importance of multidisciplinary treatment with dentists to improve the degree of xerostomia, hygiene and oral condition. <h3>References</h3> [1]Montero-Martín Javier et al. "Validation the Oral Health Impact Profile (OHIP-14sp) for adults in Spain." Medicina oral, patologia oral y cirugia bucal vol. 14,1 E44-50. Jan 2009 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.